Server for communication with an implantable medical device

ABSTRACT

A system and method for modifying the parameters of an implantable medical device includes an implantable medical device that communicates with a remote control device that, in turn, communicates through the browser of a computer or any other device capable of using mark-up language protocol. The computer optionally communicates with other computers and/or devices through a network.

CROSS REFERENCE TO RELATED APPLICATIONS

This is a continuation of U.S. patent application Ser. No. 14/696,872,filed Apr. 27, 2015 (now U.S. Pat. No. 9,244,898), which is acontinuation of Ser. No. 14/201,900, filed Mar. 9, 2014 (now U.S. Pat.No. 9,020,603), which is a continuation of Ser. No. 13/766,654, filedFeb. 13, 2013 (now U.S. Pat. No. 8,706,254), which is a continuation ofSer. No. 12/783,432, filed May 19, 2010 (now U.S. Pat. No. 8,401,661),which is a continuation of Ser. No. 10/857,390, filed May 28, 2004 (nowU.S. Pat. No. 7,742,821), which is a non-provisional of U.S. ProvisionalPatent Application Ser. No. 60/477,604, filed Jun. 11, 2003. Priority isclaimed to these applications, and these applications are incorporatedherein by reference in their entireties.

FIELD OF THE INVENTION

The present invention relates to implantable medical devices, and moreparticularly, to remote control devices for communicating with animplantable medical device and a computer.

BACKGROUND

Current implantable medical devices such as pacemakers, cochlearimplants, spinal cord stimulators, and deep brain stimulators, aretypically programmed by a specially designed remote control device, ortelemetry system, that contains a computer and a radio or magneticdevice to communicate with the implantable device. Implantable sensorsystems and infusion pumps also require telemetry systems. Implantablesensor systems sense the level of various substances within the body,such as medications, hormones, neurotransmitters, electrolytes, enzymes,gases, and glucose.

The remote control device's computer contains a specific programdesigned to control the particular type of implant. Some of the remotecontrol devices are complete in themselves. But, some other remotecontrol devices require a larger computer (sometimes called aspecial-purpose programmer, Clinician's Programmer, or Fitting Station)to configure the remote control parameters, such as speech processingstrategies or the adjustability limits of the remote control by thepatient.

Clinician's Programmers and their accompanying software programs arevery expensive. As the variety of medical devices increases, cliniciansare required to stock and track an increasing variety of special purposedevices. A clinician who does not have the appropriate special purposedevice cannot offer any assistance to a patient whose treatment requiresthe device. As a result, patients are restricted to seeking treatmentfrom a limited number of clinics. Patients who must travel longdistances to reach one of these qualified clinics are unduly burdenedwith added expense and inconvenience.

Therefore, a need exists for an implantable medical device remotecontrol system that may be controlled by a clinician without the use ofa complex and expensive Clinician's Programmer or Fitting Station.

SUMMARY

The present invention addresses the above and other needs by providing asystem for fitting, or altering the parameters of, implantable medicaldevices using only the patient's own remote control and a generalpurpose computer equipped with a web browser and network connection, orother communication means, to link to the patient's remote control.Optionally, once a web page from the remote control device is deliveredto the browser of the clinician's computer, the clinician can permit aremote user, such as another clinician or the technical support staff ofthe implant manufacturer, to view and control the parameters displayedon the web page from a remote location. Information in the clinician'sbrowser can be uploaded to a remote site, or server, to be viewed oraltered by others.

The present invention eliminates the need for clinicians to be equippedwith separate computers and/or software used to manage or control theparameters of the implant. The present invention allows a patient tosimply present his remote control device to the clinician, and theclinician is then able to interrogate and intervene as required.

BRIEF DESCRIPTION OF THE DRAWINGS

The above and other aspects of the present invention will be moreapparent from the following more particular description thereof,presented in conjunction with the following drawings wherein:

FIG. 1 is a diagram that illustrates a communication system provided bythe present invention;

FIG. 2 is a more detailed diagram of the communication system of FIG. 1;

FIG. 3 is a diagram of computer software components of a remote controldevice used with the present invention; and

FIG. 4 is a flow chart illustrating steps for using a system of thepresent invention.

Corresponding reference characters indicate corresponding componentsthroughout the several views of the drawings.

DETAILED DESCRIPTION

The following description is of the best mode presently contemplated forcarrying out the invention. This description is not to be taken in alimiting sense, but is made merely for the purpose of describing thegeneral principles of the invention. The scope of the invention shouldbe determined with reference to the claims.

Recently, others have developed communications systems similar to thepresent invention in order to monitor and control the behavior ofimplantable medical devices. For example, U.S. Pat. No. 6,442,432(issued Aug. 27, 2002) (the '432 patent), incorporated herein byreference, teaches a general purpose computer loaded with a softwareapplication that allows the computer to communicate with an interfacemedical unit connected to the general purpose computer. The interfacemedical unit also communicates with an implantable medical device (Col.13, lines 58-63). The '432 patent also teaches an interface medical unitthat downloads instructions from a remote expert server and sends theinstructions to a remote implantable medical device. Col. 13, lines10-12. Nevertheless, the '432 patent fails to teach an interface medicalunit loaded with server software capable of delivering data to thebrowser of a general purpose computer.

U.S. Pat. No. 6,497,655 (issued Dec. 24, 2002) (the '655 patent), alsoincorporated herein by reference, provides a programmer or interfacemedical unit in communication with an implantable medical device. Theprogrammer or interface medical unit is an interface between theimplantable medical device and a remote web-based expert data center(Col. 11, lines 23-27; cols. 15-16, lines 59-18; col. 16, lines 62-64).The remote web-based expert data center has several complex programmingsoftware modules that permit a physician to provide clinical care andtherapy to a patient (Cols. 21-24, claims 1, 16, and 18). The '655patent does not indicate that these software modules are delivered tothe web-based expert data center from the interface medical unit.Rather, the '655 patent indicates that the complex software modules arealready located on the web-based expert data center.

Finally, U.S. patent application Ser. No. 10/438,374 (the '374application), filed May 15, 2003, also incorporated herein by reference,provides an external device in communication with an implantable medicaldevice. The external device may communicate with distantly locatedclinician equipment. The '374 application indicates that data is sentfrom the external device to a server, to another interface device, andfinally to a general purpose personal computer (see paragraph 52 andFIG. 3).

Although the three references mentioned above teach systems and methodssimilar to the present invention, all of these systems and methods lackat least one critical component of the present invention: interfaceserver software on the remote control device itself, which serversoftware delivers data and software modules to a general purposecomputer. By loading the remote control device with interface serversoftware, a remote control device manufacturer can permit a clinician touse the remote control device to interface freely with a general purposecomputer equipped with commonly available internet browser software. Nopre-loaded, complex software modules are needed on the clinician'scomputer because all of the software modules needed to manipulate andmonitor the implantable medical device are already stored on anddelivered from the remote control device using interface serversoftware. In essence, the present invention permits a clinician to usecommunication methods and systems - including the methods and systems ofU.S. Pat. Nos. 6,442,432 and 6,497,655 and U.S. patent application Ser.No. 10/438,374—without having to purchase, stock, and operate costlyinterface equipment.

A simplified representation of the present invention is shown in FIG. 1.The present invention is a system for programming an implantable medicaldevice 100 by means of a hypertext transfer protocol server, or HTTPserver, located in a remote control device 110 and a general purposecomputer 120. HTTP is a protocol used to request and transmit filesbetween servers and browsers. A server is a software program located ona computer that provides some service on that computer to anothercomputer in a network.

The implantable medical device 100 may be any combination or multiple ofan electrical stimulator, an infusion pump, a sensor, or any otherimplantable medical device whose function can be altered by programmablecommands. The remote control device 110 may be implemented in a varietyof embodiments, including: a hand held remote control; an amulet; anecklace; a badge; a pin; a wrist-worn device, such as a watch or abracelet; a talisman; or any other worn or carried device capable ofperforming the functions of a remote control device 110.

As shown in FIG. 2, implantable medical device 100 contains a processor200, software 210, and telemetry means 220. Telemetry means 220 maycomprise a radio frequency (RF) transmitting circuit, a magneticcoupler, or other means that allows data and commands to be transferredbidirectionally with a device external to the body of a patient. Remotecontrol device 110 also contains a processor 230 including software 300,first telemetry means 240 for communicating with implantable medicaldevice 100, as well as second telemetry means 250, e.g., a wired, RF,magnetic, optical, infra-red, or other telemetry means, forcommunicating with a network 260. The network 260 may include othercomputers 120 and 270, one or more servers 280, as well as otherdevices. Encryption and/or decryption of information may be employed bythe remote control device 110, the one or more servers 280, the computer120, and/or any other data communications device of the presentinvention.

As shown in FIG. 3, remote control device software 300 contains thefollowing software modules: a device control module 310, an HTTP serversoftware module 320, and an interface server module 330. Not shown inFIG. 3 but present within the remote control device 300 are necessaryhardware components that respond to and carry out the instructions andprogram controls mandated by the various software modules. Such hardwarecomponents will be readily understood by one of ordinary skill in theart to be a part of the present invention. Device control module 310 isthe basic control program used to communicate with the implantablemedical device 100. Device control module 310 controls the operation ofimplantable medical device 100 (FIG. 2) based on a set of behavior orcontrol variables, such as electrical stimulation pulse amplitude andfrequency.

HTTP server software module 320 permits “server side scripts”, alsocalled Common Gateway Interference, or CGI, scripts, to communicate toany “client” program within the reach of network 260 (FIG. 2) (wired orwireless) that supports the HTTP protocol. HTTP server software module320 acts as a way of connecting the “server” with the “client”.Alternately, the server side scripts can act as network clients to othernetwork devices such as printers, earphones, global positioning systems,microphones, telephones, cell phones, and modems.

Interface server module 330 manages device control module 310 variables.Interface server module 330 is identified to HTTP server software module320 by a special symbolic address, called a Universal Resource Locator,or URL. Interface server module 330 assembles messages containing codesfor hypertext markup language, or HTML, forms which are passed to a“client” browser and can be presented as documents with optional fieldsthat can be filled with data. A “client” browser is a program thatpermits a computer terminal to display files and other data sent from aserver.

Referring again to FIG. 2, the “client” browser is filled with files orother data from the remote control device 110 and displayed in theterminal of computer 120. Computer 120 is capable of communicating withremote control device 110 and with other computers and devices capableof communicating using HTTP protocol. Remote control device 110 iscapable of communicating with computer 120 and other computers anddevices capable of communicating using HTTP protocol. Computer 120 andremote control device 110 communicate using wired or wireless means,including infrared, acoustic, ultrasound, magnetic, fiberoptic, USB,Firewire, ilink, or other communication channels known by those ofordinary skill in the art.

Computer 120 must be equipped with a display program compatible with theHTTP protocol, such as a web browser program. Information in the displayprogram can be transferred to and from other computers 270, servers 280,and other devices capable of reading and writing information in a localor general network by means of a wired, wireless, optical, satellite, orother communication channel known by those of ordinary skill in the art.For example, display applets or other configuration managementinformation from another device located on the general network 260 maybe sent to the web browser program of computer 120. Such applets mayincrease the aesthetics and functionality of the program displayed inthe web browser. At a minimum, however, the computer 120 must beequipped with a display program compatible with the HTTP protocol. Then,all other code compatible with the HTTP protocol may be transmitted froma network to the computer 120 to increase the functionality of thecomputer 120. A limited amount of such code may in turn be transmittedto the remote control device 110.

Referring to FIG. 4, following are sequential steps of an embodiment ofa method of operating the system of the present invention. A clinicianbegins at step 400 by placing the remote control device 110 withincommunicating range of the implantable medical device 100 and thecomputer 120. The clinician then continues by executing, in anypreferred order, the following four steps: step 402 of activatingcomputer 120, step 404 of activating remote control 110, step 406 ofactivating the wireless communications between implanted device 100 andremote control 110, and step 408 of opening a web browser withincomputer 120. The clinician then enters the URL for the “server sidescript” software of the remote control device 110 into the browser atstep 410. The interface server module 330 sends a “login form” at step412 to the browser opened in the computer 120, featuring fields foridentification, password, or other security tokens. The clinician fillsin the form and submits it to the interface server module 330 at step414.

The interface server module 330 examines the filled-in form and decidesif permission for display or modification of implanted device controlparameters should be granted at step 416. If the permission is denied,the denial is counted at step 417. If permission has been denied, e.g.,three times or less, then interface server module 330 sends an errormessage with a new “login form” to the browser at step 418. Ifpermission is denied, e.g., more than three times, the interface servermodule sends a termination message to the browser at step 420 indicatingthat login attempts were unsuccessful, and the session is terminated. Ifthe permission is granted, the interface server module 330 sends a formto the computer 120 at step 422 that is displayed in the browser withcontrol tokens at step 424 for modifying the parameters of the remotecontrol device 110.

At this point the clinician may modify each control variable through thebrowser at step 426. As the clinician modifies each control variablethrough the browser at step 428, a request is sent to the interfaceserver module 330 within the remote control 110 at step 430. Theinterface server module 330 responds to each request from the clinicianby sending out a new page displaying the control tokens for futureaction in the browser and the current device status at step 432. Theinterface server module also responds to each request from the clinicianby sending the new parameters to the implantable device 100 at step 434.Alternatively, a request may be sent to the interface server module 330to deliver all new parameters in a group to the implantable device 100after all control variables have been modified by the clinician.

Alternately, when the clinician selects a control token for terminatingthe interaction at step 426, the interface server module 330 stopssending forms to computer 120 and the session terminates at step 436.Optionally, the login process may start a timer (preferably locatedwithin the remote control device 110) which specifies a maximum time forthe interaction, after which the interface server module 330 stopssending out pages at optional step 438.

Once a session has begun, it is possible that errors may occur during asession that could potentially jeopardize the health of the patient. Inorder to avoid endangering the patient, interface server module 330requests device control module 310 to switch the implantable medicaldevice 100 to safe operations. Safe operations are a predefined set ofparameters upon which the implantable medical device 100 can properlyfunction without endangering the patient. By entering into safeoperations, the system of the present invention limits or stops thetherapy session whenever there is an error in order to ensure the safetyof the patient. Safe operations continue until the clinician initiates anew session or until the error is resolved.

Additionally, information coming from computer 120 and remote controldevice 110 may be retrieved from arbitrary server systems on a local 290or general network 260. Local network 290 is located entirely within asingle building and is any network of any devices capable ofcommunicating with each other and with computer 120. These portions mayinclude pages using markup language (such as html, xml, xhtml, sgml,dhtml, and any derivative thereof), graphics, or client side logic(sometimes called scripts or applets). Markup language is a codingsystem used to structure, index, and link files for presentation in abrowser. As a first option, remote control device 110 or the browser(under the control of an applet or script) may upload patient or devicedata to a server on the network. As a second option, the web page andapplets may exchange data with a server 280 and/or database at a remotesite on general network 260. General network 260 may include localnetwork 290 and may also include any data transfer network of devices,such as an intranet or internet established through wired (e.g.,telephone lines) and/or wireless (e.g., cell phone towers or satellitetransmissions) means. Information supplied from a remote server 280 tocomputer 120 across the general network 260 could provide a commonclient desktop interface, where a clinician could see the history of thepatient with other clinicians.

Network communication permits both easy file sharing and file upgrading.Information transferred over a network from a remote location is moreeasily upgraded than cumbersome and expensive software packages runningin a clinician's office. In addition, remote server 280 or the remotedatabase can be used to backup and clone remote control device 110 asneeded.

It is thus seen that remote control device 110 provides a gatewaybetween a physician's computer and a patient's implantable device.Remote control device 110 may further include a security device toprevent unauthorized users from impermissibly altering the parameters ofa patient's implantable medical device. For example, the security devicemay prevent impermissible alteration by acting as a physical enabler forcommunication to remote control 110 that only one with possession ofremote control device 110 may activate. One embodiment of such aphysical enabler is a recessed switch that, when activated, enablescommunications with remote control device 110 for a limited time, suchas 15 minutes. After the time expires, the switch is automaticallydeactivated and must again be activated in order for communications tocontinue. Other embodiments of physical enablers may include keycombinations, keys and locks, and other physical security tokens.

Advantageously, both patients and clinicians, spread out over a largearea, may enjoy the benefits of the present invention. The presentinvention permits implant patients the freedom to seek care from anyable clinician equipped with a general purpose computer. Clinicians areno longer required to pay for and maintain expensive special-purposeprogrammers and similar complex stations to support the programming andfitting of implantable medical devices. Further, clinicians may alsoenjoy un-cluttering their fitting areas by reducing the number ofprogramming systems in each area.

While the invention herein disclosed has been described by means ofspecific embodiments and applications thereof, numerous modificationsand variations could be made thereto by those skilled in the art withoutdeparting from the scope of the invention set forth in the claims.

What is claimed is:
 1. A system, comprising: an implantable medicaldevice; and a first device configured to directly wirelessly communicatewith the implantable medical device, wherein the first device comprisesa server configured to communicate with a second device in accordancewith a markup language protocol, and wherein the server is configured toreceive a request from the second device.
 2. The system of claim 1,wherein the first device is configured to wirelessly communicate withthe second device.
 3. The system of claim 1, wherein the first device isconfigured to communicate with the second device by a wired connection.4. The system of claim 1, wherein the server is further configured totransmit information to the second device in response to the request. 5.The system of claim 4, wherein the information is one or more of statusinformation pertaining to the implantable medical device, a securitytoken, a device control token, and a communication termination controltoken.
 6. The system of claim 4, wherein the information comprisesinformation interpretable by a browser program of the second device. 7.The system of claim 5, wherein the information comprises a login form.8. The system of claim 1, wherein the markup language protocol is anHTTP protocol.
 9. The system of claim 1, wherein the server isconfigured to communicate directly with the second device in accordancewith the markup language protocol.
 10. The system of claim 1, whereinthe request includes a URL of the first device.
 11. The system of claim1, wherein the first device is further configured to receive from thesecond device operational parameters for the implantable medical deviceafter receipt of the request, and wherein the first device is configuredto communicate the operational parameters to the implantable medicaldevice.
 12. The system of claim 1, wherein the request comprisesoperational parameters for the implantable medical device, and whereinthe first device is configured to communicate the operational parametersto the implantable medical device.
 13. The system of claim 1, whereinthe first device is hand-holdable.
 14. The system of claim 1, whereinthe first device is portable.
 15. The system of claim 1, wherein thefirst device is configured to be worn by a user.
 16. The system of claim1, wherein the first device comprises a remote control for theimplantable medical device.
 17. A communication device, comprising:telemetry circuitry configured to communicate with an implantablemedical device and with an external device; a server configured toreceive via the telemetry circuit a request from a web browser of theexternal device and to transmit via the telemetry circuitry informationto the web browser in response in accordance with a markup languageprotocol; and a portable housing containing the telemetry circuitry andthe server.
 18. The device of claim 17, wherein the information is oneor more of status information pertaining to the implantable medicaldevice, a security token, a device control token, and a communicationtermination control token.
 19. The device of claim 17, wherein theinformation comprises a login form.
 20. The device of claim 17, whereinthe markup language protocol is an HTTP protocol.
 21. The device ofclaim 17, wherein the telemetry circuitry is configured to wirelesslycommunicate directly with the implantable medical device.
 22. The deviceof claim 17, wherein the telemetry circuitry is configured to wirelesslycommunicate directly with the external device.
 23. The device of claim17, wherein the telemetry circuitry is configured to communicatedirectly with the external device by a wired connection.
 24. The deviceof claim 17, wherein the telemetry circuitry comprises first telemetrycircuitry configured to communicate with the implantable medical device,and second telemetry circuitry configured to communicate with the seconddevice.
 25. The device of claim 17, wherein the request includes a URLof the remote control device.
 26. The device of claim 17, wherein theserver is further configured to receive from the external deviceoperational parameters for the implantable medical device after receiptof the request, and wherein the telemetry circuitry is configured towirelessly communicate the operational parameters to the implantablemedical device.
 27. The device of claim 17, wherein the requestcomprises operational parameters for the implantable medical device, andwherein the telemetry circuitry is configured to wirelessly communicatethe operational parameters to the implantable medical device.
 28. Thedevice of claim 17, wherein the device is configured to be worn by auser.
 29. The device of claim 17, wherein the device is configured tooperate as a remote control from the implantable medical device.
 30. Thedevice of claim 17, wherein the housing is hand-holdable.
 31. The deviceof claim 17, wherein the device is configured to be worn by a user.